Personalized therapies for the treatment of allergic rhinitis

Introduction: Allergic rhinitis (AR) represents a global health problem, being one of the most widespread diseases worldwide and having a severe impact on patients' quality of life (QoL). Personalized therapies based on the genetic, immunological and bio-psycho-social profile (such as the genotype, the phenotype, and the endotype) of the patient aims to minimize side effects while improving the therapeutic outcomes. Also, new therapeutic targets of precision medicine are under investigation to modify the immune response to allergens and prevent the progression of atopic disease. Areas covered: We analyzed evidence regarding personalized therapies for the treatment of AR, in particular focusing on novel perspectives in allergen immunotherapy (AIT), biologics and small molecules. Expert opinion: AIT represents a therapeutic model for personalized medicine, aiming to individualize treatment on the patient's immunological and clinical profile. Moreover, the identification of the crucial role of IgE in the allergic inflammatory pathway has paved the way to investigate the therapeutic potential of targeting this antibody with omalizumab. Other biologics, as dupilumab, are currently under investigation, and promising small molecules are in development or early-stage clinical trials; however, the efficacy and safety of these drugs for the treatment of AR need to be confirmed. Finally, the pharmacoeconomic perspective must be carefully considered to identify which therapeutic strategies may represent a real novel opportunity for personalized therapied in AR.